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Report Contents Can DVD simulations be used to promote empathic behaviours and interprofessional collaboration among undergraduate healthcare students? Final Report 2014 Monash University (Lead university) Associate Professor Brett Williams (Project leader) Associate Professor Ted Brown Professor Lisa McKenna Dr Malcolm Boyle Dr Claire Palermo, Associate Professor Elizabeth Molloy Professor Debra Nestel Associate Professor Louise McCall Deakin University Professor Karen Stagnitti Edith Cowan University Associate Professor Richard Brightwell University of South Australia Susan Gilbert-Hunt Report author: Associate Professor Brett Williams http://med.monash.edu.au/cehpp/altc-empathy/ Support for the production of this report has been provided by the Australian Government Office for Learning and Teaching. The views expressed in this report do not necessarily reflect the views of the Australian Government Office for Learning and Teaching. With the exception of the Commonwealth Coat of Arms, and where otherwise noted, all material presented in this document is provided under Creative Commons Attribution- ShareAlike 3.0 Unported License http://creativecommons.org/licenses/by-sa/3.0/. The details of the relevant licence conditions are available on the Creative Commons website (accessible using the links provided) as is the full legal code for the Creative Commons Attribution-ShareAlike 3.0 Unported License http://creativecommons.org/licenses/by-sa/3.0/legalcode. Requests and inquiries concerning these rights should be addressed to: Office for Learning and Teaching Department of Education GPO Box 9880, Location code N255EL10 Sydney NSW 2001 <[email protected]> 2014 ISBN 978-1-74361-200-2 (PRINT) ISBN 978-1-74361-201-9 (PDF) ISBN 978-1-74361-202-6 (DOCX) Can DVD simulations be used to promote empathic behaviours 1 Acknowledgements We would like to acknowledge the following people who have contributed to this project in a number of different ways: Dale Wickberg (Filming Consultant) Tanya Edlington (Workshop Facilitator) David Stephens (Data Entry) Louise Sparks (Clinician) Peter Kutschera (Clinician) Sam Sevenhuysen (Clinician) Janeane Dart (Clinician) James Black (Clinician) Michael Williams (Clinician) Elizabeth Rowland (Clinician) Alex Olaussen (Clinician) Karin Muiznieks (Actor) Sue Willey (Clinician) Monica O'Halloran (Clinician) Prue Morgan (Clinician) Corey Anderson (Clinician) Josh Fielding (Actor) Hendrik Gurtwirth (Clinician) Matt Fielding (Actor) Laura Jolliffe (Clinician) Leigh Nichols-Thompson (Clinician) Damien Dambrosi (Clinician) Auntie Diane Kerr (Actor) Kristal Lee (Clinician) Amanda Pettman Kristin Lo (Clinician) Dr Hung Nguyen (Clinician) We would also like to extend our thanks to the students who participated in the workshops and completed the before and after questionnaires. We are grateful to Professor Peter O’Meara (La Trobe University) and Professor Mohammadreza Hojat (Jefferson Medical College) for their valuable insight and advice as the project external evaluators. Finally, thanks to the staff of the Office for Learning and Teaching for their guidance and support throughout the project. Can DVD simulations be used to promote empathic behaviours 3 List of acronyms used IPE Interprofessional Education IPL Interprofessional Learning IPC Interprofessional Collaboration JSE-HP-S Jefferson Scale of Empathy – Health Profession – Student version RIPLS Readiness for Interprofessional Learning Scale Can DVD simulations be used to promote empathic behaviours 4 Executive summary Empathy is a key behavioural characteristic for all health professionals to possess and apply. This importance is reflected in universities and other education providers listing empathy as one of its key generic graduate attributes. Evidence suggests that improved empathetic behaviours among healthcare professionals directly impact on the provision of healthcare services and patient outcomes (Hardee, 2003; Lewin, Skea, Entwistle, Zwarenstein, & Dick, 2001; Moore, Wilkinson, & Mercado, 2004). This improvement in healthcare outcomes is also highlighted by several recent landmark studies, where Hojat and colleagues and Del Canale and colleagues determined that physicians with high empathy levels contributed to better clinical outcomes in their patients with diabetes than other physicians with lower empathy levels (Canale, 2012; Hojat, Louis, et al., 2011). However, it is also a difficult characteristic to define, conceptualise, teach, monitor, and assess. The ‘nebulous’ properties of empathic behaviour as a theoretical construct often mean that educators fail to incorporate the explicit teaching and assessment of empathy within health science curricula. This represents a potential mismatch between what is taught by universities and what is actually needed within the healthcare workforce. Health professionals rely on establishing a provider-patient/client relationship and rapport with patients/clients (and their families and caregivers) in order to promote communication, trust, patient satisfaction, and delivery of appropriate patient/client assessment and intervention services. In other words, the health professional must have an ability to empathise with the patient/client and their family members as well as to understand a patient’s/client’s perspective to develop a successful health provider-patient/client relationship with attitudes of commitment and compassion to the other person’s situation (Lauder, Reynolds, Smith, & Sharkey, 2002). A growing number of writers claim that teaching empathy in an interprofessional education setting is an effective educational approach in developing empathic behaviours (Crandall & Marion, 2009; Leaviss, 2000; O’Connell, Fuhrel-Forbisb, & Dangb, 2007). This project had two aims: 1. Develop an interprofessional empathy behaviour education toolkit that includes a range of interprofessional empathy DVD simulations and workshop resources, and 2. Evaluate the effectiveness of the interprofessional empathy behaviour education toolkit when used with students from a range of healthcare disciplines through exploring empathy and interprofessional levels before and after the DVD simulation workshop. Can DVD simulations be used to promote empathic behaviours 5 An online and hard-copy toolkit has been developed and includes three DVD simulations, teaching and learning resources for workshops and over ten additional assessment tasks that can be tailored to individual needs and different educational contexts (i.e. undergraduate, postgraduate or continuing professional development). The empathy education toolkit was evaluated using a mixed methods approach. A total of 31 interprofessional empathy workshops were delivered at four universities with over 300 students from 13 different healthcare professions. Quantitative and qualitative data analysis highlight this project has been a valuable learning experience that has added to baseline understanding of empathy and interprofessional collaborative learning. Before and after results show that self-reported empathy levels statistically improved at six weeks following the interprofessional empathy workshops, and that statistically significant improvements were also shown in teamwork and collaboration, professional identity, and better clarification of their roles and responsibilities in the healthcare system. Qualitative findings also suggest greater understanding of their personal perceptions of empathy, patient centredness and workshop impact. These mixed methodological results suggest the workshops and the toolkit have both statistically and practically had an effect on the promotion of empathy and students’ readiness for interprofessional collaboration. A number of recommendations have arisen from this project: Recommendation 1: It is recommended that healthcare stakeholders from the various levels of higher education interested in empathy consider using the DVD-simulation toolkit in guiding and promoting empathy and interprofessional collaboration in undergraduate curricula. Recommendation 2: It is recommended that ongoing continuous quality evaluation of the workshops and the curricular integration of additional assessment tasks be carried out across the different healthcare professions. Recommendation 3: It is recommended that ongoing continuous quality evaluation of the workshops and the curricular integration of additional assessment tasks be carried out across both undergraduate and postgraduate levels of study and also across both tertiary and vocational educational sectors. Can DVD simulations be used to promote empathic behaviours 6 Recommendation 4: It is recommended that tertiary institutions provide ongoing financial support for further examination of self-reported empathy levels among healthcare students and curricula renewal. This support should also foster collaborative opportunities with other non-cognate professions. Recommendation 5: It is recommended that other toolkits involving non-technical skills (such as listening, communication, teamwork, situational awareness and leadership etc.) that are important graduate attributes for healthcare professionals be developed and integrated into national curricula. Recommendation 6: It is recommended that future work compare and contrast empathetic behaviours with different patient/client diagnostic groups across different healthcare environments. Can DVD simulations be used to promote empathic behaviours 7 Table of Contents Acknowledgements ...................................................................................................................
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